Universität zu Köln

Ersoy, Lebriz, Ristau, Tina, Kirchhof, Bernd and Liakopoulos, Sandra (2014). Response to anti-VEGF therapy in patients with subretinal fluid and pigment epithelial detachment on spectral-domain optical coherence tomography. Graefes Arch. Clin. Exp. Ophthalmol., 252 (6). S. 889 - 898. NEW YORK: SPRINGER. ISSN 1435-702X

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Abstract

Purpose To analyse the long-term functional and morphological response of a specific choroidal neovascular membrane (CNV) phenotype to anti-vascular endothelial growth factor (VEGF) therapy. Methods Data from 30 eyes of 30 consecutive patients with subretinal fluid (SRF) and fibrovascular pigment epithelial detachment (PED) due to CNV on spectral-domain optical coherence tomography (SDOCT) with a follow-up of at least 20 months were retrospectively collected. Main outcome measures included change in visual acuity, quantitative and qualitative parameters on SDOCT [photoreceptor layer, outer nuclear layer (ONL), choroid, PED, SRF] and on fluorescein angiography (CNV activity). Subjects were divided into responders and non-responders based on morphological and functional aspects. Results An average number of 20.23 +/- 9.9 anti-VEGF injections were administered during a mean follow-up of 40.25 +/- 13.5 months. Fourteen eyes were categorized as morphological non-responders, 12 as functional non-responders and eight as complete non-responders. Complete non-responders were significantly younger than complete responders (68.5+4.5 vs 74.3+6.8 years; p < 0.05) and presented thinner baseline ONL values (68.43+15.2 vs103.5+32.8 mu m; p < 0.05). Intermediate or large drusen as typical features for age-related macular degeneration (AMD) were less frequently present in complete non-responders; however, this was not statistically significant (62.5 % vs 91.7 %; p = 0.25). Conclusions Our preliminary findings indicate that eyes with the specific SDOCT phenotype with isolated fibrovascular PED and SRF frequently demonstrate non-response to anti-VEGF therapy, and the underlying disease mechanism may be different from AMD. Larger prospective trials are required to validate those results, and to develop strategies to improve the morphological as well as functional outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ersoy, Lebriz UNSPECIFIED UNSPECIFIED UNSPECIFIED Ristau, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirchhof, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-436542
DOI:	10.1007/s00417-013-2519-9
Journal or Publication Title:	Graefes Arch. Clin. Exp. Ophthalmol.
Volume:	252
Number:	6
Page Range:	S. 889 - 898
Date:	2014
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-702X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHOROIDAL NEOVASCULARIZATION SECONDARY; MACULAR DEGENERATION; INTRAVITREAL RANIBIZUMAB; VISUAL-ACUITY; PHOTODYNAMIC THERAPY; SUBGROUP ANALYSIS; BEVACIZUMAB; EYES; TACHYPHYLAXIS; AFLIBERCEPT Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43654